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Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to investigate the effect of lateral meniscal posterior root avulsions combined with intact meniscofemoral ligaments (MFLs), deficient MFLs, anterior cruciate ligament (ACL) tears and reconstructions, and root repairs using an established tibiofemoral contact mechanics testing protocol.

Methods

Ten fresh-frozen cadaveric knees were tested with six knee conditions (1: intact; 2: lateral meniscal posterior root avulsion; 3: root avulsion and deficient MFLs; 4: condition 3 with ACL tear; 5: condition 4 with ACL reconstruction; 6: ACL reconstruction with root repair) at five flexion angles (0°, 30°, 45°, 60°, and 90°), under a 1000-N axial load. Contact area and pressure were measured with Tekscan sensors.

Results

Compared to the intact state, condition 2 did not significantly change lateral compartment contact area or pressure. Changes in contact mechanics were greater at increased flexion angles; for condition 3 at 0° and 90°, contact area decreased 37 and 52 % [95 % CI (21–53) and (39–66), respectively] and mean contact pressure increased 55 and 87 % [95 % CI (33–76) and (59–114), respectively]. Root repair with ACL reconstruction was not significantly different from the intact state.

Conclusions

The MFLs protect the lateral compartment from changes in contact mechanics in the setting of a lateral meniscal posterior root avulsion, whereas a combination of lateral meniscal root avulsion and deficient MFLs leads to significant changes. Concurrent ACL reconstruction and lateral meniscal root repair restore mean contact pressure and area to the intact state and are recommended in this combined injury to prevent or slow the development of lateral compartment arthritis.

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Authors and Affiliations

  1. Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA

    Andrew G. Geeslin, David Civitarese, Travis Lee Turnbull, Grant J. Dornan, Fernando A. Fuso & Robert F. LaPrade

  2. Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA

    Andrew G. Geeslin

  3. The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA

    Robert F. LaPrade

Authors
  1. Andrew G. Geeslin
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  2. David Civitarese
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  3. Travis Lee Turnbull
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  4. Grant J. Dornan
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  5. Fernando A. Fuso
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  6. Robert F. LaPrade
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Correspondence to Robert F. LaPrade.

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Geeslin, A.G., Civitarese, D., Turnbull, T.L. et al. Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics. Knee Surg Sports Traumatol Arthrosc 24, 1469–1477 (2016). https://doi.org/10.1007/s00167-015-3742-1

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  • DOI: https://doi.org/10.1007/s00167-015-3742-1

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